A Simple In Vitro Test to Select Stools for Fecal Microbiota Transplantation to Limit Intestinal Carriage of Extensively Drug-Resistant Bacteria

• Published in: Microorganisms (Basel) Vol. 11; no. 11; p. 2753
• Main Authors: Salandre, Angélique, Delannoy, Johanne, Goudiaby, Marie Thérèse Barba, Barbut, Frédéric, Thomas, Muriel, Waligora-Dupriet, Anne-Judith, Kapel, Nathalie
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.11.2023; MDPI
• Subjects: Agar; Antibiotic resistance; Antibiotics; Antimicrobial agents; Bacteria; Bacterial diseases; Bacterial infections; Bacteriology; Biochemistry, Molecular Biology; Colonization; Control; Decolonization; diagnostic techniques; Drug resistance; Drug resistance in microorganisms; Enterococcus faecium; Enterococcus faecium VanA; fecal microbiota transplant; Fecal microflora; Feces; Food and Nutrition; Health aspects; Human health and pathology; In vitro methods and tests; intestinal microorganisms; Intestine; intestines; Klebsiella; Klebsiella pneumoniae; Klebsiella pneumoniae OXA-48; Laboratory animals; Life Sciences; mice; Microbiology and Parasitology; Microbiota; Microorganisms; Molecular biology; Multidrug resistance; multiple drug resistance; Nosocomial infections; Performance evaluation; Pilot projects; pre-clinical model; Public health; screening method; Small intestine; therapeutics; Tissues and Organs; Transplantation; Transplants & implants; XDR bacteria; France; fecal microbiota transplant; screening method; human microbiota-associated mice; XDR bacteria; Enterococcus faecium VanA; pre-clinical model; fecal microbiota transplant XDR bacteria Klebsiella pneumoniae OXA-48 Enterococcus faecium VanA screening method pre-clinical model human microbiota-associated mice; Klebsiella pneumoniae OXA-48
• DOI: 10.3390/microorganisms11112753
• ISSN: 2076-2607

Treatment options for multidrug-resistant bacterial infections are limited and often ineffective. Fecal microbiota transplantation (FMT) has emerged as a promising therapy for intestinal multidrug-resistant bacterial decolonization. However, clinical results are discrepant. The aim of our pilot study was to evaluate the screening performance of a simple diagnostic tool to select fecal samples that will be effective in decolonizing the intestine. Fecal samples from 10 healthy subjects were selected. We developed an agar spot test to evaluate their antagonistic activity toward the growth of VanA Enterococcus faecium and OXA-48-producing Klebsiella pneumoniae, two of the most serious and urgent threats of antibiotic resistance. Most fecal samples were able to limit the growth of both bacteria in vitro but with large inter-individual variation. The samples with the highest and lowest antagonistic activity were used for FMT in a mouse model of intestinal colonization. FMT was not successful in reducing intestinal colonization with VanA Enterococcus faecium, whereas FMT performed with the fecal sample showing the highest activity on the agar spot test was able to significantly reduce the intestinal colonization of mice with Klebsiella pneumoniae OXA-48. The agar spot test could thus serve as a reliable screening tool to select stool samples with the best potential to eradicate/reduce multidrug-resistant bacteria carriage after FMT.